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Life before death: identifying preparatory grief through the development of a new measurement in advanced cancer patients (PGAC)

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Abstract

Goals of work

This paper describes the development of a self-rating scale to measure preparatory grief in advanced cancer patients.

Patients and methods

The Preparatory Grief in Advanced Cancer patients (PGAC) instrument incorporates seven multi-items scales. The final sample consisted of 200 patients. The questionnaire was completed at baseline and 3 days later with a cross-validation sample of 100 patients.

Main results

The average time required to complete the questionnaire was 9 min. All scales met the minimum standards of reliability (Cronbach’s alpha coefficient >0.70). The test–retest reliability in terms of Spearman-rho coefficient was also satisfactory (p<0.05). Validity was demonstrated by content validity, factor analysis, convergence and discriminative validity, inter-scales correlations, concurrent validity with the Hospital Anxiety and Depression Scale (HADS) and known-group validity with the Eastern Cooperative Oncology Group (ECOG) performance status.

Conclusions

The PGAC is a reliable and valid measure for the assessment of anticipatory grief in patients with advanced stage cancer.

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Author information

Authors and Affiliations

  1. Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, University of Athens, 27 Korinthias Str., 115 26, Athens, Greece

    Kyriaki Mystakidou, Eleni Tsilika, Efi Parpa & Emmanuela Katsouda

  2. School of Medicine, Aeginition University Hospital, 78 Vas. Sofias Ave., 11528, Athens, Greece

    Pavlos Sakkas & Costas Soldatos

Authors
  1. Kyriaki Mystakidou
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  2. Eleni Tsilika
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  3. Efi Parpa
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  4. Emmanuela Katsouda
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  5. Pavlos Sakkas
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  6. Costas Soldatos
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Corresponding author

Correspondence to Kyriaki Mystakidou.

Preparatory Grief in Advanced Cancer Patients

Preparatory Grief in Advanced Cancer Patients

A number of statements are given below that describe people’s reactions to having cancer. Please write the appropriate number to the right of each statement in the box, indicating how much you agree or disagree at present. For example, if the statement “disagree” apply to you then you should insert number 0 in the box. Remember there are no right or wrong answers. Answers: Disagree=0, Disagree a little=1, Agree a little=2, Agree=3.

  1. 1.

    I have lost my interest in family and friends. _

  2. 2.

    I have lost my interest in activities which I was pleased to be involved with. _

  3. 3.

    I have difficulties in falling asleep because I am thinking of my Illness. _

  4. 4.

    I cry all the time. _

  5. 5.

    I cannot accept my illness. _

  6. 6.

    I cannot accept the possibility of death. _

  7. 7.

    I feel often that what is happening to me is unfair. _

  8. 8.

    I feel very sad. _

  9. 9.

    I feel that I have not adjusted to my illness. _

  10. 10.

    I feel alone. _

  11. 11.

    I am extremely afraid of the unknown. _

  12. 12.

    I feel angry about what has happened to me. _

  13. 13.

    I am afraid of being abandoned by my family. _

  14. 14.

    I pray to God more than usual. _

  15. 15.

    I believe what is happening to me is God’s will. _

  16. 16.

    I believe that I will overcome my health problem. _

  17. 17.

    I believe that I am a burden to my family and it would be better if I died. _

  18. 18.

    I feel that I am still a useful and necessary person. _

  19. 19.

    I feel upset. _

  20. 20.

    I feel anger. _

  21. 21.

    I feel that I have unfulfilled wishes. _

  22. 22.

    I feel that I have unfinished business that I have to take care of. _

  23. 23.

    I feel that death would be a release. _

  24. 24.

    I cannot recognise my body anymore. _

  25. 25.

    I believe in life after death. _

  26. 26.

    I am afraid that I have lost my dignity. _

  27. 27.

    I feel I have lost my independence. _

  28. 28.

    I would like to live up to 100 years old. _

  29. 29.

    Recently I have often had a high pulse rate. _

  30. 30.

    I am not interested in anything any more. _

  31. 31.

    I have lost my faith in God. _

Thank you very much for your cooperation.

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Mystakidou, K., Tsilika, E., Parpa, E. et al. Life before death: identifying preparatory grief through the development of a new measurement in advanced cancer patients (PGAC). Support Care Cancer 13, 834–841 (2005). https://doi.org/10.1007/s00520-005-0797-4

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  • DOI: https://doi.org/10.1007/s00520-005-0797-4

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